Vascularized Bone Graft in Mangled Hand Reconstruction

Abstract

Extensive bone defects especially in conjunction with associated coverage involvement in mangled hands, pose significant challenges to hand and upper extremity surgeons. Vascularized bone grafts often play a vital role for effective treatment now-a-days. It not only bypasses the drawbacks of conventional grafts but also allows for simultaneous one stage reconstruction of its coverage as well as repairs other injured structures.Preoperative evaluation of mangled hand is crucial, the injury extent, including circulation, patient expectations and clinical reality should be all taken into consideration before finalizing the reconstruction plan. The fibula bone and other vascularized bone flaps such as iliac crest bone and medial femoral condyle and some others as well as corresponding spare part can provide effective solutions. Especially important considerations about surgeons’ experience and expertise , donor site morbidity , postoperative care and rehabilitation are essential for optimal outcomes. In this article , we would like to share our current practicing vascularized bone flaps in mangled hand reconstructions.